Cervical Biopsy and Endometril Biopsy Procedures

A cervical biopsy is a process in which the tissue is removed from the cervix to check for cervical cancer or any precancerous conditions.

There are various ways in which a cervical biopsy can be performed:

1.    Punch biopsy

In this procedure, a tissue sample is removed using a circular blade.

2.    Cone biopsy

A cone-shaped piece is removed from cervix’s tissue with the help of laser.

3.    Endocervical curettage (ECC)

The lining of the endocervical canal is scraped with the use of a narrow instrument named curette.

Why might I need a cervical biopsy?

It can be used when there are issues diagnosed during a pelvic exam or a Pap test. A positive result for Human Papillomavirus (HPV) also calls for a cervical biopsy.

In some cases, a cervical biopsy is performed as a part of a colposcopy. A colposcopy is a procedure in which an instrument with a special lens is used to get a proper view of the cervical tissues.

A cervical biopsy may also be used to diagnose and help treat the following conditions:

1.    Growth of Noncancerous polyps on the cervix
2.    Exposure of Diethylstilbestrol (DES) increases the risk of cancer.
3.    Genital warts, which may be a sign of infection with HPV.

Tell your healthcare provider if you are conceiving or you are sensitive to iodine or medicines.

Before the procedure

Before you schedule an appointment for the procedure, make sure you go through the following tips:

•    Have your doctor tell the process to you.
•    Sign a consent form that gives the hospital permission to do the procedure.
•    You don’t need to stop drinking or eating before the procedure. However, if your biopsy requires the use of anesthesia, you might have to fast for a few hours before the procedure.
•    Make sure the doctor knows about the things you are taking like medicines, anesthetic medicines, tape, latex, etc. Also, make sure that the doctor knows about all the medications you have been taking including over-the-counter medications, prescriptions, and herbal supplements.
•    Do not use medicines, vaginal creams, or tampons for at least 1 day before the process.
•    Do not have sex for at least 24 hours before the procedure.
•    You will be given a pain reliever 30 minutes before the biopsy starts.
•    Get a sanitary pad for yourself before the surgery starts.

During the procedure

Depending on your condition, you will be given local or general anesthesia. After that, the process goes as follows:

1.    An instrument named speculum will be put inside your vagina spreading its walls to reach the cervix.
2.    Sometimes, the doctor will use a colposcopy which is an instrument with a special lens to see the cervical tissues. It is put at the opening of the vagina.
3.    Next, the cervix is cleaned and soaked with a vinegar solution. This will turn the abnormal tissues white. You will feel a burning sensation. Next, the cervix is coated using an iodine solution.
4.    Next, forceps or tenaculum will be used to hold the cervix steady.
5.    One or small tissue will be removed. You will feel a slight cramp. Cells from inside of the cervical canal can be removed using an endocervical curette.
6.    Medicine will be used to treat bleeding.
7.    Lastly, the tissues are sent to the lab for testing.

After the procedure

The type of biopsy and whether the anesthesia was used or not will determine the length of your recovery period. There will be some mild cramping, spotting, and vaginal discharge. Do not use tampons are have sex for a week after the biopsy.

You can go back to your normal diet. Get immediate medical attention if you have any one of the following:

•    Bleeding
•    Fever and/or chills
•    Severe lower abdominal pain
•    Foul-smelling drainage from your vagina

ENDOMETRIAL BIOPSY

What is an endometrial biopsy?

The endometrial biopsy is a surgical procedure in which endometrium, a small tissue from the uterus lining is obtained. Once the endometrium is obtained, it is examined to either look for the presence of abnormal cells or check the effects of the hormones on the tissue.

During the menstrual cycle, the endometrium nourishes a fetus. If the implantation of the fertilized egg does not happen, the endometrium along with blood and mucus make up the menstrual flow that leaves the vagina. After menopause, menstruation stops and there is no bleeding.

Reasons for the procedure

The procedure is done if the woman is going through any of the following:

1.    Abnormal menstrual, or menopause bleeding
2.    Absence of uterine bleeding
3.    To check the effects of hormone therapy
4.    Uterine infections like endometritis
5.    Abnormal cells or cancer

Before the procedure

•    Understand the complete procedure. Ask the questions and clear all your doubts.
•    Sign the consent form giving the hospital permission to do this procedure on you.
•    No prior fasting or sedation is required. However, in some cases, a pain reliever is given 30 minutes before the procedure.
•    Make sure your doctor is aware of your sensitivity, allergies to anything including medication, anesthesia, iodine, tape, latex, etc. Make sure the medications include over-the-counter and prescribed medications, herbal products, and dietary supplements.
•    Get someone to drive you home after the procedure. Also, bring a sanitary pad.

During the procedure

It is an outpatient procedure that goes as follows:

1.    An instrument named Speculum will be inserted into your vagina. This will expose the cervix by spreading the walls of the vagina apart.
2.    Your cervix will be cleaned using an antiseptic solution.
3.    Next, the area will be numbed using medications or a numbing spray.
4.    Tenaculum, a type of forceps will hold the cervix ready for the procedure.
5.    Then, a thin rod-like instrument named a uterine sound is inserted into the cervical opening. This is done to determine the location for biopsy and the length of the uterus.
6.    After this, a catheter will be inserted into the uterus through the cervical opening. The inner tube that creates the suction at the end of the catheter is withdrawn. Then, the tip of the catheter is gently rotated and moved to collect small pieces of endometrial tissue.
7.    The catheter and speculum are removed and the tissue is sent to a lab.

After the procedure

After the procedure, rest for a few minutes before you go home. You might need a sanitary pad for bleeding. You might also have some spotting, cramping, and vaginal bleeding. Do not douche, use tampons or have sex for at least 2 to 3 days after the procedure. Also, don’t do any strenuous activity.

Notify your doctor if you have:

•    Excessive bleeding
•    Fever and/or chills
•    Foul-smelling vaginal discharge
•    Severe lower abdominal pain